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De-functioning stomas: a prospective controlled trial comparing loop ileostomy with loop transverse colostomy.

N S Williams, D G Nasmyth, D Jones

    The British Journal of Surgery
    |July 1, 1986
    PubMed
    Summary
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    For colorectal surgery patients needing a defunctioning stoma, loop ileostomy is superior to transverse loop colostomy. Ileostomies result in fewer problems, less odor, and fewer appliance changes, making them the preferred choice.

    Area of Science:

    • Colorectal Surgery
    • Surgical Stomas
    • Gastroenterology

    Background:

    • Defunctioning stomas are sometimes necessary after colorectal surgery.
    • Choosing the appropriate stoma type is crucial for patient outcomes.
    • Loop ileostomy and transverse loop colostomy are common options.

    Purpose of the Study:

    • To compare the outcomes of loop ileostomy versus transverse loop colostomy in patients requiring a defunctioning stoma.
    • To evaluate stoma-related complications, patient-reported issues, and wound infections.

    Main Methods:

    • Randomized allocation of patients to either loop ileostomy (n=23) or transverse loop colostomy (n=24).
    • Comprehensive assessments during construction, postoperatively, during outpatient supervision, and before/after stoma closure.

    Related Experiment Videos

  • Objective evaluation of distal bowel defunction.

    • Main Results:

    • Loop ileostomy demonstrated significantly less odor (P<0.01) and fewer appliance changes (P<0.05) compared to colostomy.
    • Fewer patients with ileostomy (18%) experienced significant stoma management problems versus colostomy (58%, P<0.05).
    • Wound infection rates were significantly lower after ileostomy closure than colostomy closure.

    Conclusions:

    • Both loop ileostomy and transverse loop colostomy effectively defunction the distal bowel.
    • Loop ileostomy is recommended as the primary procedure when a defunctioning stoma is required for the distal colorectum due to superior patient outcomes and fewer complications.